I was diagnosed with Afib about 3 yrs ago. I sometimes wonder if I do have Afib because I am not aware of any symptoms. I take Losartan and Diltiazem and Xarelto . Just recently was taken off of Propranolol.
My cardiologist is proposing to implant a Watchman device. I have reservations about undergoing the procedure. Is it worth the risk just in order to get off the anticoagulant?
I am 81 yrs old and otherwise in fairly good health.
Personally I wouldn't go that route and I'm a couple of years younger. If you were considerably younger(20 or 30 years) I can see an argument for such procedures but not just for the sake of doing it.
I am tending to agree with you the more I think about it. Thanks.
There may be some age related concerns about increased bleed risk from your anticoagulants, so best to query your cardiologist for the reasoning behind the recommendation.
Also, if your insurance or pocketbook allows, a second or third opinion might be an order and I would get those opinions from an electrophysiologist (ep) not just Cardiologist, at a top 10 rated cardiac hospital. (One good list is US News and World Reports.)
Since Covid, more and more US hospitals are offering remote video consultations so you may not even have to travel.
Also keep in mind that many doctors want you to remain on low dose aspirin for life post Watchman Implant, which for some present other issues.
Take your time, get some opinions and good luck with your decision.
Jim
The bleed risk is what he mentioned,for instance in the case of and accident or injury. I am thinking I would rather take that risk instead of the risk of the procedure.
My mum has afib (she also doesn't feel it), she has been on 2.5mg twice daily of the anticoagulant apixaban for some years. She is 96 now!
Thanks for that encouragement. Your mum sounds wonderful.
She is! It gets a bit more difficult now as her memory isn't so good and she can be a bit challenging .My best friend, my angel, my mum ❤️
She had her bladder removed and a stoma created at the age of 75 in an eight hour operation and she was back with me in Tenerife for Christmas less that 6 months later - 21 years ago next month.
How lovely for you to still have your mum. Treasure every moment with her as l am sure you do. She sounds an absolute darling. 🥰
Afib is often symptomless.Whenever docs check my heart I am mostly in afib that I do not feel .I would continue to take the anticoagulant for your a fib. It is a small price to pay to keep a stroke at bay.
Thanks! I do intend to keep taking the anticoagulant if I choose not to have the Watchman.
I wouldn’t unless you have no alternative because you cannot tolerate a/cs. The older you are, the greater the risk and there are risks with this procedure which mean you may still need a/c’s.
If you are not aware of any of your AF symptoms and get on OK with your current medication then I would question this. I am just a little younger than you and had a colonoscopy 3 weeks ago which left me totally shattered for a couple of weeks - so much so that I had emergency blood tests and a head MRI to check electrolytes and whether or not I had had a stroke whilst having the procedure. As nothing was found and no polyps or biopsies needed to be taken I have decided I will be unlikely to have this again as it is just not worth the time spent feeling unwell afterwards. I want to feel as fit as I can for as much of the time I have left as I can after all. The brain scan found that my brain was good for my age and hardly any signs of atrophy you would usually find with someone nearly 81 - my wife disagrees after telling me the same thing half a dozen times. 
I am more and more convinced that anesthesia is not a friend of people our age!
If you search HU for Watchman you will find 117 threads, and diverse opinions!
Thanks! I have done that search and read many of them ,not all. I seemed that much of it was 5-6 yrs old and I was hoping for more current opinions,which I am getting here. I am thankful for all feedback!
the trouble with the Watchman is two fold.
1). Yes you can get off anti coagulants but you must take aspirin for the rest of your life. Aspirin is dangerous to take the older you get. Not a good idea. I’d rather stay on anti coagulant.
2). The watchman is fitted inside the LAA and even though they say it fits snug, it can leak as well as a clot can form on the device.
Make sure you do your own research and not depend on your doctor convincing you.
After reading advice from all you helpful people I have pretty much decided not to get it done. Thanks!
I think you are wise to question the logic behind this proposal.
I can't comment on the Watchman but I know quite a few people who get no apparent symptoms with their AF and some of them only discovered it when they went for pre ops for surgery. The belief is that there are thousands of folk who have it and haven't a clue.Myself, on the other hand, sadly, very symptomatic.
Hi
You are like me.
Diltiazem controls my rapid Heart Rate. a CCB Calcium Channel Blocker.
I take Bisoprolol for BP, you take Lopressor - an ACE.
I did have uncontrolled sweating and I stopped to regain energy.
Not sure, when you are controlled' with no symptoms that I would undertake any procedures.
cheri JOY. 75. (NZ)
I too am grateful for these comments. Thank you. I am 73 and discovered my AF only because of a pre op assessment. I'm on bisoprolol and apixaban. Absolutely no afib symptoms that I notice. My cardiologist discussed a pacemaker with me and said he didn't think it was worth the risk of upsetting things and on balance better to "leave well enough alone". I agreed and am enjoyably getting on with what's left of life!
Personally no from me and not being rude, but not at your age. At your age it is far too invasive. If it’s not broken don’t fix it. You are in good health so stay as you are and enjoy your life.
I'm 70 plus, in permanent AFib like you, on an anti-coagulant regime and am asymptomatic. Life is good. I decided against Watchman because, frankly, I couldn't justify an invasive procedure that might still, post implant, require anti-coagulant treatment in many cases. Adding in sedation and device failure, the risk/reward just didn't add up for me.
Hi . I am 78 yrs old and about 5 yrs ago had massive gastro bleeds from Xaralto.My cardiologist/ electrophysilogist recommended a Watchman as i was unable to take anticoagulants.
I was quite unsure and researched a lot to get as much information as i could. After careful consideration I agreed to have it done following an ablation.
I know i did the right thing . I am now off all anticoagulants and antiplatelets.
Procedure and recovery went well.
Feel so much better.
Talk to your cardiologist and ask as many questions as you need. Choose an electrophysiologist who is well experienced in performing the procedure.
I am more than willing to answer any further questions you may have of my experience.
Good luck.
I too have been recommended a watchman device as I am so allergic to anticoagulants. My legs are in a terrible mess and hurt a great deal, apart from looking as if I’ve been in a bad accident!
Not! My reading has led me to a strong preference for safety reasons for the Atriclip device (fitted outside the heart) rather than a Watchman device (fitted inside the heart) if I ever had to make a decision about occluding the LAA.
I suggest you find the latest reports about the safety of both devices if you decide to pursue this further, although you seem to be asking the appropriate questions. Good luck.
Dr Wolf (in Houston), who invented the Wolf minimaze procedure only uses the Atriclip to occlude the LAA. Perhaps look at his website for info about the Atriclip ...
Thank you, I appreciate the information!
I am 82 and in good health other than the troublesome Afib, which I now hope is on the run after two ablations, one for Afib, the other for atypical Aflutter arising in the left atrium.
I also had a Watchman implant 3 months ago. It’s healing up well, the embolization proceeding as it should, meaning my body is miraculously growing tissue over it that will complete the closure of the left atrial appendage where over 90% of blood clots form.
I come from a family with a history of strokes. I have cared at home for three family members felled by lingering strokes. I’ll do whatever I can not to die that way. The Watchman gives me such peace of mind because it lowers my stroke risk hugely. My personal history clearly influenced my decision in favor of a Watchman.
Also important to me is that the Watchman allows me to get off blood thinners for the rest of my life. Ugh. As other responses to your post show, some if not many people find them of no mind. I do. They have a negative effect on my quality of life. I’m active and tired of bandaids on my hands. I choose not to restrict my active lifestyle for fear of injury resulting in serious bleeding. I find it disturbing to look at my hands and see a new purple-blue splotch and wonder where it came from, and wonder if I bleed so easily where I can see it, right under my skin, what’s happening in the hidden places of my body I can’t see? My 55lb dog landed full force on my tummy; if a simple tap of my hand causes bleeding, what about a forceful blow like that to my insides? I’ve had three serious falls resulting in broken bones. Another fall in which I hit my head could kill me. (I’m going to PT to improve my balance and overall strength—though getting off drugs has in itself improved my balance.)
The risk of internal bleeding is practically nil if not taking blood thinners, but rises dramatically if one is on blood thinners. I’d prefer not to risk a bleeding stomach ulcer from longterm use of a drug that can negatively affect my stomach lining or risk any kind of internal bleeding, even micro-bleeding I am unaware of.
In addition, I have aches and pains not unusual for an 82-year-old. They include TMJ and osteoarthritis. The best pain relief for me is aspirin, which is forbidden if on blood thinners, or wise use of NSAIDs, also forbidden. Acetaminophen is of limited efficacy because it is not an anti-inflammatory. And longterm use can do in your liver. When I’m in pain, I want to be able to take aspirin. Pain is a great motivator. I’m familiar with aspirin and know what food to have in my stomach if I take some. It has never caused me any problems for 60+ years. I choose to take my chances with baby aspirin rather than a DOAC. I would even feel comfortable stopping baby aspirin if I needed/wanted to because I have the Watchman. Stopping a DOAC without a Watchman would be risky.
I chose a Watchman because it goes a long way toward correcting the source of the problem: it eliminates a place in the heart (left atrial appendage) where blood can pool and clotting agents can hang out together and form a blood clot when blood flow from normal heart beating is interrupted as it is in those of us with Afib. If the overwhelming majority of blood clots in people with Afib form in the left atrial appendage, I prefer to have it sealed off.
Those are some of my reasons for proactively seeking and getting a Watchman:
I don’t want a stroke. I’m old and prone to falling. Bleeding like a stuck pig from a minor insignificant wound is not pleasant, nor are hands with purple-blue splotches. I choose not to invite internal bleeding risk where otherwise there is none. I need access to pain relief nostrums other than acetaminophen, and certainly do not want to turn to opioids. A Watchman gives me comfort by closing off the place most blood clots form. I choose not to become an overmedicated old lady lining up her pills two or three times a day. All drugs have side effects, including anticoagulants, such as life-threatening bleeding, or less significant bleeding such as nosebleeds and bleeding gums, and nausea or other gastrointestinal upsets to our body’s normal functioning.
The fewer the drugs, the better.
These are all personal decisions. I know you’ll make the right one for yourself.
I myself am delighted to have a Watchman.
Thank you for taking the time for a thorough explanation. I am looking at all comments and will weigh my risks against each other and hopefully make the right decision. ❤️
Sweetmelody,
First, let me say that your post is very thoughtful and well written. I am curious - did the purple splotches go away after you got off of anti-coagulants?
I was interested in that as well. Actually,I have always bruised easily,even before being on anticoagulant. I really can’t tell any difference it has made in my bruising or bleeding.
I’m still on apixaban for another two and a half months, then free. 🎈Blood thinners or anti-platelets are recommended for 6 months until the device in the left atrial appendage is completely closed over, blocked off by tissue that miraculously grows across the Watchman. Mine has closed over nicely according to the last TEE, but my be-on-the-safe-side EP still has me on anticoagulation. Until the tissue completely covers the device, there could be tiny crevices where a clot could lurk—hence the medication. Chances are low.
I didn’t bruise before I started apixaban; I see no reason to believe any bruising will continue after I stop it. I’ll let the forum know.
Hi again. One last thought: bottom line, ask your cardiologist why s/he has proposed a Watchman. That’s your best source of information, not necessarily this forum, though this forum is invaluable in learning about the ins and outs that real people with Afib have experienced. I’ve learned a lot from this forum and have found comfort from kindred spirits. But in making weighty decisions, I look to my EP and my cardiologist, and I make sure I understand what they are saying.
His reason was to lessen the risk of blood loss in case of an accident or serious injury.
That’s one of my reasons, too. Falling while walking through the woods or maneuvering in my garden badly enough to cause bleeding. (I’ve done both.) Tripping on a stairstep. (I did, and broke an arm.) Slipping on ice and maybe hitting my head, possibly causing a hemorrhagic stroke. (I’ve slipped and fallen on ice, more than once. Hit my head quite badly one time while learning to cross-country ski, but I was 20 years younger and not on blood thinners.). Fainting and crashing to the floor. (That happened to me within 24 hours of starting diltiazem; nobody warned me. I have low blood pressure to begin with, which the doctor failed to take into account. It was just lucky that I didn’t hit my head on the corner of the bedside table. It was close.) A car accident, heaven forbid, that would require immediate surgery. (That has not happened, whew, but a few years back I did fall badly downhill in a stupid—on my part—garden accident and had a burst fracture in my spine requiring immediate surgery. I wasn’t on blood thinners, again whew.) Stuff happens, especially if one stays active at an older age. I prefer not to be on anticoagulants the rest of my life with a worry of excessive bleeding hovering over me if similar “stuff happens” and engendering a hesitancy to engage fully in activities I enjoy. It’s a personal decision. For me personally, being off anticoagulants improves my quality of life
my husband didn’t have any symptoms before his stroke up until a couple of days before . So I’d air on the side of precaution before coming off any tabs . Take care
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